Hemorrhagic Shock from Bleeding Pseudoaneurysm of Deep Circumflex Iliac Artery after Abdominal Paracentesis

Authors

  • Jutamas Saoraya Department of Emergency Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society and The Faculty of Medicine, Chulalongkorn University
  • Khrongwong Musikatavorn Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University
  • Chuthaporn Surawech Department of Radiology, Division of Diagnostic Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Keywords:

paracentesis, pseudoaneurysm, hemorrhagic shock

Abstract

We reported a case of bleeding pseudoaneurysm of a deep circumflex iliac artery (DCIA) after abdominal paracentesis. A 63-year-old female with cirrhosis came to the emergency department due to abdominal pain and altered mental status after abdominal paracentesis three days ago. The computed tomography of the abdomen showed an intramuscular hematoma at the abdominal wall. The angiogram revealed extravasation from a pseudoaneurysm from a branch of the left DCIA. The DCIA is the most commonly injured artery from abdominal wall procedures that necessitated endovascular treatment. Prevention could involve the use of ultrasound-assisted paracentesis.

References

De Gottardi A, Thévenot T, Spahr L, Morard I, Bresson-Hadni S, Torres F, et al. Risk of complications after abdominal paracentesis in cirrhotic patients: a prospective study. Clin Gastroenterol Hepatol. 2009 Aug;7(8):906-9. doi: 10.1016/j.cgh.2009.05.004.

Satija B, Kumar S, Duggal RK, Kohli S. Deep circumflex iliac artery pseudoaneurysm as a complication of paracentesis. J Clin Imaging Sci. 2012;2:10. doi: 10.4103/2156-7514.94022.

Kalantari J, Nashed MH, Smith JC. Post paracentesis deep circumflex iliac artery injury identified at angiography, an underreported complication. CVIR Endovasc. 2019 Jul 19;2(1):24. doi: 10.1186/s42155-019-0068-y.

Millington SJ, Koenig S. Better With Ultrasound: Paracentesis. Chest. 2018 Jul;154(1):177-184. doi: 10.1016/j.chest.2018.03.034.

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Published

2020-06-30

How to Cite

1.
Saoraya J, Musikatavorn K, Surawech C. Hemorrhagic Shock from Bleeding Pseudoaneurysm of Deep Circumflex Iliac Artery after Abdominal Paracentesis. TJEM [Internet]. 2020 Jun. 30 [cited 2024 Nov. 16];2(1):31-6. Available from: https://he02.tci-thaijo.org/index.php/TJEM/article/view/249830